Alaska physician manpower characteristics and trends.
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An 1-year study of the 1989 Exxon Valdez oil spill found that spill residues on the oiled shorelines rapidly lost toxicity through weathering. After 1990, toxicity of sediments remained at only a few heavily oiled, isolated locations in Prince William Sound (AK, USA), as measured by a standard amphipod bioassay using Rhepoxynius abronius. Data from 648 sediment samples taken during the 1990 to 1993 period were statistically analyzed to determine the relationship between the total concentration of 39 parent and methyl-substituted polycyclic aromatic hydrocarbons (defined as total polycyclic aromatic hydrocarbons [TPAH]) and amphipod mortality and the effect of oil weathering on toxicity. A logistic regression model yielded estimates of the lower threshold, LC10 (lethal concentration to 10% of the population), and LC50 (median lethal concentration) values of 2,600, 4,100, and 10,750 ng/g TPAH (dry wt), respectively. Estimates of the threshold and LC50 values in this field study relate well to corresponding sediment quality guideline (SQG) values reported in the literature. For sediment TPAH concentrations >2,600 ng/g, samples with high mortality values (>90%) had relatively high fractions of naphthalenes and those with low mortality (<20%) had relatively high fractions of chrysenes. By 1999, the median sediment TPAH concentration of 117 ng/g for the post-1989 worst-case sites studied were well below the 2,600 ng/g toxicity threshold value, confirming the lack of potential for long-term toxic effects. Analysis of biological community structure parameters for sediment samples taken concurrently found that species richness and Shannon diversity decreased with increasing TPAH above the 2,600 ng/g threshold, demonstrating a correspondence between sediment bioassay results and biological community effects in the field. The low probability of exposure to toxic concentrations of weathered spill residues at the worst-case sites sampled in this study is consistent with the rapid overall recovery of shoreline biota observed in 1990 to 1991.
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Diabetes affects American Indians/Alaska Natives (AI/ANs) disproportionately compared with other racial/ethnic populations and has been increasing in prevalence in AI/AN populations during the past 16 years. To examine trends in diabetes prevalence among AI/ANs and the overall U.S. population and to describe disparities among these two populations, CDC analyzed data from the Indian Health Service (IHS) and the Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicate that diabetes continues to affect AI/ANs disproportionately and is becoming more common among younger populations. To combat this epidemic, knowledge and interventions from clinical trials and best-practice models should be translated to community-based prevention programs within AI/AN communities.
Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infection (LRTI) in young children worldwide. Approximately half of all LRTI-associated hospitalizations are caused by bronchiolitis, with RSV accounting for 50%-80% of all bronchiolitis cases. Bronchiolitis is an infection of the bronchial and bronchiolar epithelial cells, with subsequent inflammation and edema resulting in airway obstruction. This process manifests clinically as cough, wheezing, tachypnea, and respiratory distress. Because of the association between bronchiolitis and RSV infection, bronchiolitis is a good indicator of RSV disease; therefore, prevention strategies for RSV should reduce the rate of bronchiolitis. Rates of bronchiolitis-associated hospitalization for American Indian/Alaska Native (AI/AN) children are approximately twice that for the general population of U.S. children. This report describes the first estimate of rates of outpatient bronchiolitis-associated visits and updates rates of bronchiolitis-associated hospitalizations in these populations. Rates of bronchiolitis-associated outpatient visits and hospitalizations were higher for AI/AN children than for other U.S. children, and hospitalization rates for both groups increased during 1990-2000. This report underscores the high burden of bronchiolitis and the need for effective prevention programs for AI/AN communities.
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